Degenerative Joint Disease

Question 1

When do early degenerative OA changes start

Answer 1

20s

Question 2

OA risk factors

Answer 2

Obesity
Abnormal mechanical loading
Inherited T2 collagen defects in premature polyarticulad OA
inheritance - nodal and erosive OA
other arthritic conditions
Systemic inflammation

Question 3

What measurement shows the axis of pull of the quadriceps tendon and the ligament of the patella

Answer 3

Q angle

Question 4

Normal q angle

Answer 4

15-20*

Question 5

What landmarks are used to find q angle

Answer 5

ASIS
centre of patella
Tibial tuberosity

Question 6

Why is a angle greater in women than men

Answer 6

Wider pelvis

Question 7

Does a greater Q angle put more strain on the medial or lateral compartment of the knee

Answer 7

Medial

Question 8

Most common 3 comorbid conditions

Answer 8

Joint problems
Cardiometabolic
Mental health

Question 9

How does obesity increase OA risk

Answer 9

Poor diet - less protective nutrients and more pro inflammatory substances
Incr stress in joints
Incr adipose derived inflammatory mediators

Question 10

2 types of OA

Answer 10

Primary OA
Secondary OA

Question 11

Pri OA cause

Answer 11

Idiopathic

Question 12

Difference between primary and secondary OA

Answer 12

Primary - idiopathic
Secondary - caused by mechanical joint abnormality, inflammatory disease, endocrine disorders,metabolic disorders

Question 13

Is x ray the best means of assessment or diagnosis of OA

Answer 13

Assessment

Question 14

4 signs of OA on XR

Answer 14

Joint space narrowing
Osteophytes
Subchondral sclerosis
Subchondral cysts
Trabeculae fractures
LOSSt

Question 15

What does synovial fluid entering the bone in OA lead to

Answer 15

Trabeculae fractures
Subchondral cysts

Question 16

Which imaging methods are best for OA diagnosis

Answer 16

MRI
arthroscopy
Ultrasound

Question 17

How many grades are there of OA

Answer 17

5 (0,1,2,3,4,)

Question 18

OA grades

Answer 18

0 - normal
1 - bone spur no pain
2 - 1st time symptoms, pain on walking, more spurs
3 - moderate OA, pain + stiffness, cartilage damage
4 - severe OA, dramatic joint space loss, high pain when moving

Question 19

OA physical signs

Answer 19

Crepitus
Bony enlargements
Deformity
Instability/pseudolaxity
Restricted movement
Effusion
Muscle weakness or wasting

Question 20

Crepitus

Answer 20

Popping/creaking sound when moving joint from loss of articular cartilage

Question 21

What causes visible deformity of joints in OA

Answer 21

Osteophytes
Loss of articular cartilage

Question 22

Pseudolaxity

Answer 22

Narrowed joint space but ligaments still original length so more lax making joint unstable

Question 23

What causes effusion in OA

Answer 23

Osteophytes irritate synovium
Pro inflammatory cytokines

Question 24

What nodes form in the DIP and PIP joints in nodal generalised OA

Answer 24

DIP - herberdens node
PIP - Bouchards node

Question 25

Which joints are effected by nodal generalised OA

Answer 25

Small joints of hands

Question 26

Erosive OA is a severe subset of what type of OA

Answer 26

Nodal generalised OA

Question 27

Hand deformities caused by erosive RA

Answer 27

Gull wing deformity
Sawtooth deformity
Erosions in centre and edges of PIP and DIPs

Question 28

What causes full wing and saw tooth deformities

Answer 28

Erosion of cartilage in DIPs and PIPs by erosive OA

Question 29

Why can erosive OA be confused with RA

Answer 29

erosive OA is inflammatory

Question 30

Erosive OA risk factors

Answer 30

Middle age / post menopausal
Female
Dyslipidaemia
Metabolic syndrome